title: Pyogenic liver abscess among children in a medical center in Central Taiwan.
abstract: BACKGROUND
  Pediatric pyogenic liver abscess is uncommon. This study aimed to investigate the clinical characteristics, radiologic features, pathogens, duration of hospitalization, and management of pediatric pyogenic liver abscess.
  
  
  METHODS
  Pediatric patients with pyogenic liver abscess admitted to the China Medical University Hospital from 1995 to 2011 were reviewed. Their clinical characteristics, radiological features, laboratory data, clinical management, and outcomes were analyzed. Those with liver abscess due to the complication of oncologic disease were excluded.
  
  
  RESULTS
  Fifteen patients were diagnosed with pyogenic liver abscess. Their most common symptoms were fever and abdominal pain. Eight (53.0%) had leukocytosis (>15000/μL) and elevated C-reactive protein (CRP) level (>10 mg/dL). The main imaging presentation was a single abscess in right lobe of the liver (13/15, 86.7%). Blood culture were mainly negative (12/15, 80.0%). Pathogenic microorganisms cultured from pus revealed Klebsiella pneumoniae (6/15, 40.0%) and Streptococcus spp. (6/15, 40.0%) as the two most common pathogens. Percutaneous abscess drainage followed by adequate parenteral antibiotics were effective interventions. Hospitalization of at least 2 weeks was needed in most cases. There were no mortalities.
  
  
  CONCLUSIONS
  Pyogenic liver abscess should be considered in children presenting with fever, abdominal pain, and leukocytosis with a high CRP level. Most cases involve a single lesion on right lobe of the liver. K. pneumoniae and Streptococcus spp. are the two most common pathogens. Drainage with adequate antibiotics has significantly good response.
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Yu-Lung
authors.initials: YL
authors.lastname: Hsu
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Yen
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Tsung-Hsueh
authors.initials: TH
authors.lastname: Hsieh
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan.
authors.forename: Hsiu-Mei
authors.initials: HM
authors.lastname: Wei
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, China Medical University Hospital, China Medical University School of Medicine, Taichung, Taiwan. Electronic address: kapihw@mail.cmuh.org.tw.
authors.forename: Kao-Pin
authors.initials: KP
authors.lastname: Hwang
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification* / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007902:Length of Stay; D046290:Liver Abscess, Pyogenic / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D008297:Male; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Children; Klebsiella pneumoniae; Pyogenic liver abscess; Streptococcus spp